<div style="float:left;">
	<form id="addNewNoteForm" method="post" action="<?=$this->baseUrl?>/clinical-notes.raw/process-add-note">
	<div style="margin-left:10px;width:350px;">
	<div style="width:325px;margin-left:auto;margin-right:auto;">
	<strong><?=__("Title")?>:</strong>
	<?=$this->form->clinicalNoteDefinitionIdInput('FormSelect',array('options'=>$this->clinicalNoteDefinitions->toArray('clinicalNoteDefinitionId','title'),'multiple'=>'multiple','style'=>'width:325px;height:100px;'))?>
	</div>
<br />
	<div class="formRow">
	<dt><label for="clinical-note-authoring-user-id" class="optional"><?=__("Author")?></label></dt>
	<select id="clinical-note-authoring-person-id"  name="clinicalNote[authoringPersonId]" style="width:325px;">
        <?foreach(Provider::getArray() as $personId => $name):?>
                <option value="<?=$personId?>" <?if ($personId == $this->currentPersonId):?>selected="selected"<?endif;?>><?=$name?></option>
        <?endforeach;?>
        </select>
	</div>
<br />
<div class="formRow" style="padding-top:4px;">
        <dt><label for="clinical-note-date-time" class="optional"><?=__("Date/Time")?></label></dt>
        <input type="text" name="clinicalNote[dateTime]" id="clinical-note-date-time" size="16" helper="formText" value="<?=date('Y-m-d H:i:s')?>"/>
        </div>
<br style="clear:left"/>
<div style="text-align:right;margin-top:10px;">
	<input type="button" value="<?=__("Cancel")?>" onClick="parent.closeWindowNewNote()"/>
	<input type="button" value="<?=__("Select")?>" onClick="dojo.xhrPost ({url: '<?=$this->baseUrl?>/clinical-notes.raw/process-add-note?personId=<?=$this->personId?>',form: 'addNewNoteForm', handleAs: 'json', load: function (data) {
if (typeof addedNewNote == 'function') {addedNewNote(data.clinicalNoteId);} else { dashboardInnerLayout.dhxWins.getTopmostWindow().close();  }
}, error: function (er) {alert('err: ' + er)}});" />
</div>
</form>
</div>
